The most appropriate agent for treating varicella zoster infection in an immunocompromised host is which?

The most appropriate agent for treating varicella zoster infection in an immunocompromised host is which?

• A. Ganciclovir
• B. Acyclovir
• C. Ceftriaxone
• D. Chloramphenicol

Answer: (B)

Treating varicella zoster in someone with a compromised immune system requires an antiviral that is highly active against the virus and safely used in severe disease. Acyclovir does exactly this: it’s a guanosine analog that is activated by the viral thymidine kinase inside infected cells and then inhibits viral DNA polymerase, effectively halting viral replication. In immunocompromised patients, intravenous acyclovir is preferred because it starts working quickly to control dissemination and prevent complications like pneumonia or encephalitis. Ganciclovir also targets herpesviruses but is more toxic to the bone marrow and is mainly used for CMV infections; it’s not the first choice for VZV in this population. Ceftriaxone and chloramphenicol are antibiotics and do not treat viral infections; chloramphenicol has significant toxicity risks and is not appropriate for this scenario. If acyclovir-resistant VZV were to occur, alternatives such as foscarnet or cidofovir may be considered.

Treating varicella zoster in someone with a compromised immune system requires an antiviral that is highly active against the virus and safely used in severe disease. Acyclovir does exactly this: it’s a guanosine analog that is activated by the viral thymidine kinase inside infected cells and then inhibits viral DNA polymerase, effectively halting viral replication. In immunocompromised patients, intravenous acyclovir is preferred because it starts working quickly to control dissemination and prevent complications like pneumonia or encephalitis.

Ganciclovir also targets herpesviruses but is more toxic to the bone marrow and is mainly used for CMV infections; it’s not the first choice for VZV in this population. Ceftriaxone and chloramphenicol are antibiotics and do not treat viral infections; chloramphenicol has significant toxicity risks and is not appropriate for this scenario. If acyclovir-resistant VZV were to occur, alternatives such as foscarnet or cidofovir may be considered.